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Medicare in Montana: How to Apply and More

April 6, 2022

Medicare in Montana: How to Apply and More

Health insurance coverage is an important investment that can make a big difference in how much you pay for health care costs like doctor's visits and hospital stays. As your lifestyle and healthcare needs change as you age, you may find yourself seeking different health insurance options to avoid gaps in coverage.

For the eligible residents in Montana, Medicare is a federal program that provides affordable coverage with various options to meet your needs. Like other types of health insurance, understanding the terms of Medicare and the costs associated with coverage can be confusing. This guide will answer common questions about Medicare in Montana.

Does Montana have Medicare?

Yes, Medicare is a federal program available to qualifying individuals in all 50 states. Medicare beneficiaries can choose to get their coverage through private providers or directly through the federal government.

Who is Eligible for Medicare in Montana?

Like all other states, Medicare is only available to certain people in Montana. To qualify for Medicare, you must be a US citizen or be a permanent legal resident who has lived in the US for at least five years and meet one of the following requirements:

  • Age 65 or older
  • [Under 65 with a qualifying disability] or have been receiving disability benefits for at least 24 months
  • Individuals with end-stage kidney failure or ALS

The Parts of Medicare in Montana

Medicare is made up of four basic parts and supplemental plans (Medigap) to help you avoid extra costs. While most Medicare beneficiaries are enrolled in Part A and Part B (which make up Original Medicare), some people choose additional options to avoid coverage gaps and limit out-of-pocket costs.

  • Medicare Part A (hospital coverage) is part of Original Medicare and is provided by the federal government. This coverage is supplied at no cost to eligible citizens.
  • Medicare Part B (medical coverage) is the part of Original Medicare that covers routine doctor visits.
  • Medicare Part C (Medicare Advantage) is offered through private insurers and is a full replacement for Original Medicare. Some Part C plans also include dental coverage and other benefits not included with Original Medicare.
  • Medicare Part D (prescription drug coverage) supplies coverage for prescription medications. These plans are available as a single plan to supplement Original Medicare or as a part of a Medicare Advantage plan (MAPD).

How Does Medicare Work in Montana?

If you're approaching the age of 65 and you don't meet the qualifications for automatic enrollment, it's a good idea to begin looking into your Medicare coverage options. You can enroll in Medicare up to three months prior to your 65th birthday. If you're still working and have employer-provided health insurance or coverage through a spouse, you don't have to sign up for Medicare while you (or your spouse) are still working. You can wait to sign up until you (or your spouse) stop working or you lose your health insurance, whichever comes first.

Since most beneficiaries are eligible to receive Medicare Part A without a premium, it's common to enroll in Part A while still enrolled in employer-provided coverage. You can choose whether to enroll in Part B or to delay Part B enrollment. If you choose to use Medicare in conjunction with your current insurance plan, there are specific rules about how job-based insurance works with Medicare.

If you have no other insurance and plan to depend entirely on Medicare for your health coverage, it's important to learn what copay and deductibles will apply to your healthcare services. Original Medicare includes some coverage for hospital expenses and routine medical care. However, some copayments and deductibles apply, and Original Medicare has no annual out-of-pocket limit. For this reason, beneficiaries who choose Original Medicare often enroll in a Medicare Part D plan for prescription coverage and a Medigap plan to limit out-of-pocket costs.

How do I Apply for Medicare in Montana?

If you're eligible for Medicare in Montana, there are a few different ways to apply. Some people are automatically enrolled in Medicare and will receive a welcome packet in the mail before they turn 65. If you're not automatically enrolled, you'll have an initial enrollment period to make choices about coverage. You can also make changes to your coverage during the annual enrollment period (AEP) which occurs between October 15th and December 7th.

Some people are automatically enrolled in Medicare Part A and Part B. Automatic enrollment usually only applies to people who already receive Social Security benefits, those who are disabled and have been receiving Social Security benefits for 24 months, and retirees from the Railroad Retirement Board.

Are Medicare Advantage Plans Available in Montana?

Yes, Medicare Advantage plans are available to all individuals who are eligible for Medicare in Montana. There are more than 550,000 people with a Medicare Advantage plan in Montana.

Medicare Advantage plans in Montana (also known as Part C) are available through private insurance providers to all individuals who are eligible for Medicare. While Medicare Advantage plans vary in coverage, they all provide at least the same amount of coverage as Original Medicare. Depending on the plan you choose, Medicare Advantage may also offer additional benefits like vision, dental, and fitness membership coverage.

Learn More About Medicare in Montana

For eligible individuals, Medicare can be a great way to get the health coverage you need. Each year, Medicare beneficiaries have the option to review their current Medicare plan and make changes to fit their current needs and budget.

Your medical needs are always changing. Medicare plans and the costs associated with these plans routinely change as well. Navigating all these changes and finding the information you need to choose a plan can be difficult. Our licensed insurance agents can help you choose a Medicare plan based on your needs. Whether you want to compare plans or speak with a licensed agent, our experts are here to help you navigate the process of choosing a Medicare plan that fits your needs and budget.

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